Job Details

Prior Authorization Representative II

Position Number: 6301017
Location: Salt Lake City, UT
Position Type: Health - Healthcare Administration

Prior Authorization Representative II

Job Summary

University Medical Billing (UMB) is a fully remote department that is viewed as the premier billing office for the University of Utah School of Medicine, serving over 1,800 providers and 30 different specialties across Utah and surrounding states. We strive to be a great place to work while providing the best service to our customers. Our leaders and employees value collaboration, innovation, and accountability - attributes a successful candidate will exemplify.

As the Prior Authorization Representative Senior, you will be responsible for training and auditing internal and external staff in the prior and denials workflows. This position is not responsible for providing care to patients.

Employment is contingent on the successful completion of a background check and the adherence to departmental policies, including UMB's Telecommuting Agreement which requires a distraction-free and HIPAA compliant workplace, cameras on for all virtual calls/meetings, and the ability to work during office hours or assigned shift (M-F, approximately 8am to 5pm Mountain Time) regardless of what time zone you live in. Additionally, new hires are required to provide their own monitors (two) and reliable internet service.

Compensation & Benefits
The starting salary for this position is $29 to $32 per hour, depending on experience. Members of UMB are eligible for a bonus based on department performance. All team members are eligible for the University's comprehensive benefit package that includes 90% employer-paid medical insurance, a generous 14.2% retirement contribution, reduced tuition, PTO and holiday pay, and more.

Employment is contingent on the successful completion of a background check and the adherence to departmental policies, including UMB's Telecommuting Agreement which requires a distraction-free and HIPAA compliant workplace, cameras on for all virtual calls/meetings, and the ability to work during office hours or assigned shift (M-F, approximately 8am to 5pm Mountain Time) regardless of what time zone you live in. Additionally, new hires are required to provide their own monitors (two) and reliable internet service.

Responsibilities
Essential Functions

Audit internal and external staff on all workflows within Pre-Auth and Authorization Denials.
Provide training and presentations to others on authorization procedures and practices, one on one or in group settings.
Responsible for identifying and summarizing authorization concerns and communicating to supervisors and managers.
Conduct high-level analysis of reports; provide feedback and recommendations to aid in reduction of denials.
Quality Review for business associate team to provide education and report of trends for accuracy improvement.
Manage policy, procedure, and workflow updates.
Meets productivity and accuracy expectations of the position.
Other duties as assigned.

This job description is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Minimum Qualifications
Required
Three years of experience in a health care financial setting, or equivalency (one year of education can be substituted for two years of related work experience).
Six months of experience as a Prior Authorization Rep I or equivalent prior-authorization experience.

Preferred
Previous experience with insurance and prior authorizations.
ICD/CPT Coding Certification.
Inpatient and day surgery prior authorizations experience.

Preferences
An especially qualified candidate will also possess the following:

Four years of experience in a health care financial setting.
Two years of prior authorization experience, including robust experience and understanding of prior authorization workflows and authorization denials.
Ability to train and audit internal and external staff.
ICD/CPT Coding Certification.

Disclaimer
This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It's not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Special Instructions
While UMB is a remote department and this role will be performed remotely, interested applicants should note the following:

This role is expected to work during UMB office hours which are Monday through Friday, 8am to 5pm Mountain Time.
The University of Utah is committed to providing jobs to individuals located in Utah, and sees remote roles like this as an opportunity to provide amazing employment opportunities to those living in remote areas of the state. As such, Utah-based applicants may be prioritized in the screening process.
At this time, the University of Utah is unable to employ individuals living in California, Colorado, New York, Oregon, or Washington.

Requisition Number: PRN42190B
Full Time or Part Time? Full Time
Work Schedule Summary: UMB Office Hours; M-F 8:00am to 5:00pm Mountain Time
Department: 00209 - Univ Medical Billing - Oper
Location: Other
Pay Rate Range: $29-$32 per hour
Close Date: 7/4/2025
Open Until Filled:

To apply, visit https://utah.peopleadmin.com/postings/183970